80. Invest to save is the wrong aim, it should
be invest to produce better services?
(Mavis McDonald) I think the criteria for the programme
goes slightly wider than just the kind of pure invest to save,
although some of the projects are clearly focussed on that, but
others are about better methodology.
(Mr Mitchell) We have just advertised a contract to
do a systematic evaluation of the invest to save budget programme.
The requirement is to provide a full external evaluation of the
programme to provide HM Treasury with independent assurance that
it is adding value to the future delivery of public services.
I would not want to prejudge whether or not there are savings
or not.

81. The answer is you do not know but you are
trying to find out?
(Mr Mitchell) Yes.

82. One of the classic examples of where departments
are not working together, and therefore a lot of money is being
wasted, is the question of bed blocking in the Health Service
and the lack of money in social services, where, of course, you
have the added difficulty if you are talking about the Health
Service money through general taxation and national sources and
social services money provided by local authorities, a lot of
that comes from central resources, nevertheless you are providing
money in different ways, one nationally and one locally, how much
of the invest to save programme has been used on that sort of
problem?
(Mr Mitchell) I will have to find out and respond
to you on that. I am not sure it has been used on that area. The
issue of delayed discharge of older people from hospital, which
we know as bed blocking, has been a long running issue for a long
time now.

83. Which is exactly why I thought you might
have done something about it?
(Mr Mitchell) It tends to be addressed through channelling
funding for that purpose either into the health system or into
the local government system. I will find out whether any of the
money has been used in that way.[4]

84. Thank you. My follow up question on the
same subject is, why has it now become necessary to try to merge
the two departments to cover this problem rather than to merge
the two systems, if you like, to cover this problem rather than
to use the joint working we are referring to in this document?
(Mavis McDonald) I am not sure which department you
are referring to?

85. My understanding is that in order to overcome
the bed blocking social services money and health money is going
to be administered together.
(Mavis McDonald) A significant part of social services
money is still going to go through local government revenue support
grants. There may be special programmes to support this. I am
sorry, we have no expertise amongst us on the arrangements for
that.

86. Let me leave that one and turn to Ms Eisenstadt,
to what extent has your project been liaising with the National
Play Group Association?
(Ms Eisenstadt) The Preschool Learning Alliance, that
is what it is called now, the PLA, is one of the major providers
in Sure Start partnership. The evidence we have is the two voluntary
organisations who are most often in partnerships are the National
Childminders Association and the Preschool Learning Alliance.
At programme level there is a lot of cooperation with the Preschool
Learning Alliance. In terms of being lead partners, they are lead
partners on fewer programmes, but they are key providers and partners
on partnership.

87. Why then are they having such difficulty
in maintaining their services, certainly in some of the rural
areas, as a result of the increase in the sort of work that you
are doing?
(Ms Eisenstadt) The key issue is less Sure Start and
much more child care in general, if we are trying to push on working
families and the kind of child care that will enable women on
benefit to get out to work, most play groups only offer two hours
possibly two mornings or three mornings a week. The DFES is encouraging
play groups to make arrangements for longer care so that they
can enable people to work. The way that play groups operate traditionally
has not been convenient for working mothers. It is the demand
in child care for working mothers that has created the problem
for play groups, much less than Sure Start.

88. Can I come back to Miss Casey and ask you
a few questions about the cost, in particular, of your work? Firstly,
let me say I value enormously your work, I am not one of those
who is going to attack the work you are doing. It does seem to
me there is a question mark hanging over the cost. The costs as
given in the report, £70,000 per place lost, that, presumably,
is simply a question of dividing the overall drop, which is a
question of a lot in and a lot out, divided by the overall drop
in the total amount of money spent during the three years?
(Ms Casey) I have to be honest here and say that the
National Audit Office very helpfully drew this information together.
I cannot say that I did that myself.

89. Can I just check with the National Audit
Office?
(Mr Whitehouse) That is the methodology.

90. It is not, in any sense, any sort of an
estimate of how much you spend per person coming on to the streets,
it is simply the drop itself?
(Mr Whitehouse) It is the drop itself.

91. We have been told that something like 3,000
people have been handled, and if you include the extra 1,000 who
have gone you could say it is 4,000, 3,000 have come off and there
is a drop of 1,000.
(Ms Casey) That is right. There are two issues, first
of all dealing with people with mental health problems and drug
and alcohol problems is not cheap. Even if your starting point
was you wanted to help people that were really at the very, very
vulnerable end the public would be horrified if they thought they
were out there, in other words kids that have come out of care,
then end up with a drug problem and are populating the streets
of central London, Birmingham or Manchester, who they do not want
them there. Helping somebody with an institutional background,
in other words quite messed up, with all sorts of problems, then
adding to that a drug problem, actually getting somebody help
is not cheap anyway. My point is helping people who are very vulnerable
is not cheap and you have to decide whether you want to invest
in those human beings and help them move inside. We decided we
did and we have helped a lot of those people move inside.

92. If you look at the cost of a decent room,
just spending £70,000 on a room most people would say is
a hell of a lot of money. I assume you are going to tell us it
is nothing like that, it is more the cost of the medical help,
the cost of social care help.
(Ms Casey) Behind that figure there is a larger volume
of people who receive help, it is not a per capita costing. One
of the bits of work we are doing at the moment is looking in some
detail, we are doing it ourselves within the unit, and we are
getting somebody else to look at it externally, to try and weigh
up some of the cost benefit analysis bit, also some of the performance
issues as well, why do some hostels manage to help people who
are very vulnerable move permanently off the streets, whereas
others do not seem so good at it and they move back to the street.
Why do some contact and assessment teams seem to do a very good
job with very vulnerable people and others do not. That is my
job. This is what you guys are paying me to do. You are paying
me to scrutinise some of this.

93. Will we be having to spend the same amount
of money year-by-year in order to keep the figure down at this
relatively low level we have now got to?
(Ms Casey) We need to look quite carefully at that.
In order to prevent new people coming to the streets you have
to leave a very strong prevention programme in place in order
to sustain the figure. I do not see there are going to be major
savings made that can be put else where.

94. The last question is given that we have
now got down to a much smaller figure are we making the problem
harder and harder for ourselves in the sense that those who are
now still there are just the new ones who have come on in the
last few months or are they the ones who are so difficult to get
off the streets because of the intensity of their problems that
it is going to cost you more and more per person to reduce the
number any further?
(Ms Casey) Ask me back in six months and I will give
you the answer to the question. What we are doing at the moment
is taking a long hard look at who is there. All the evidence at
the moment seems to point to the fact that though there is a flow
of new people there are now the services in place to make sure
those people get off the street. We are taking a look at why some
of the people who are out there have actually been out there for
quite some time and I tell you now it is not as straight forward
as saying they have got mental health problems and they are unable
to be treated. It is complicated, we need to look at it carefully,
we need to look at it calmly. We need to look at the evidence
and then decide what is the most appropriate way to take this
initiative forward.

Chairman: Thank you, Mr Rendel. Nick Gibb.

Mr Gibb

95. Thank you, Chairman. Despite the interesting
questioning we have had from colleagues and, if I may say so,
very effective performance by Louise Casey, this is not actually
a report about the Rough Sleepers Unit, nor is it actually a report
about Sure Start, it is actually a report entitled "Joining
Up to Improve Public Services". My question really is to
Sir John. Why are we doing a report on joining up to improve public
services? This is a report, as far as I can tell, that is measuring
concepts, is about internal concepts, internal management concepts,
within Whitehall and how they deliver these various projects.
Surely what we should be doing is measuring the outputs of those
projects in separate reports so we can question people like Louise
Casey in detail and see an in-depth report into what she is doing
rather than just looking at this very nebulous concept. What I
thought the NAO did was to examine the provision of programmes
and projects and services provided by the state to the public
so we then can see whether they are getting good value for taxpayers'
money. Why are we examining a concept that does not get provided
to the public?
(Sir John Bourn) The reason that we decided to do
a report on this subject was that joint working is a new programme,
is a new approach. When ministers decided to launch this policy
they recognised that there were difficulties in Whitehall departments
working together. Reference has been made this afternoon to a
silo mentality. If you are going to try to deliver services in
a more co-ordinated, joined up way than has been the practice
in the past the question arises as to how you set yourself up
to do that. What this report is about is the way in which for
a series of programmes we can make some suggestions at this stage
as to what needs to be put in place to increase the chance of
a successful delivery of these programmes. In some cases it is
already clear, some elements of the outcomes to be achieved. In
other cases it will be a longer term outcome. It will be, of course,
for the C&AG and the NAO to decide at a later stage whether
we wish to reinforce the analysis we have done at the early stage
with an analysis of the outcomes finally achieved, and we probably
will, but making some suggestions as to how to make a success
of the programme before it has reached completion is, of course,
part of our continuing work. We do a lot of reports which are
around programmes which are in the course of generation, defence
programmes, a whole range of other programmes. That is the reason
for doing it. Plus, when we discussed our programme of work, as
we do each year with the Members of the Committee, no Member spoke
against the idea of looking into this and a number of Members
have spoken to me encouraging the NAO to look at things before
the curtain has come down, you might say, to bring work of this
kind. Although this is not the only sort of study that we do,
as you quite rightly say, and we will continue to do a range of
studies, those are the reasons why we did this one.

96. I am not against looking at programmes before
they are completed, that is a very effective thing to do, but
this is not, this is looking at a concept and it is a concept
that I do not really see requires a report. Working together and
co-ordinating efforts is an obvious method of working. If you
have a policy or programme that is well managed by capable industrious
people, people like Louise Casey, with strong opinions, a very
capable person, they will inevitably co-ordinate with other organisations
and outfits if he or she feels it is the right thing to do. Why
do we need to examine the effectiveness of that method? If you
examine the output of an organisation that has the objective to
provide a good service to the public you will inevitably find
out if it is effective or not effective. It may be the reason
that the organisation is not effective because it is not co-ordinating
activities between one another, there may be other reasons, it
may be the people at the top are incompetent. Why do we need to
have a report and use the valuable resources of the NAO looking
at the implementation of what is really a concept? It does not
even come within the three Es that the NAO has as its main lodestone.
(Sir John Bourn) I would say that it is more than
evaluating a concept. What it is looking at is how joined up working
can operate in such a way as to achieve the three Es. It is quite
right to say that there will be something to be done when there
is more history behind the programmes but I think that if one
were to say that Government departments could launch programmes
and everything could be left there and the results would come
out because the people who were engaged in it were people of intelligence
and goodwill then that would be enough but certainly my experience,
and history, would say that is not enough. What you can do is
you can look at the arrangements that were set in place, you can
make suggestions as to what needs to be taken into account in
designing and in particular in evaluating the programmes, and
that is the justification for doing this piece of work. It is
looking at more than a concept, it is looking at a series of programmes
and analysing what can be suggested to increase their chance of
success.

97. How then do you distinguish what is the
causal link between an effective programme and a non-effective
programme? How do you know that it is the joint working that is
responsible for a good outcome or a bad outcome of a programme
if you are just doing a report on joint working? How do you know
it is the joint working that is delivering the result and not
the £201 billion that has been spent on the project? How
can you delineate between which is responsible for the outcome?
(Sir John Bourn) In a way you could say at the end
of the day perhaps you do not have to because the outcome is a
function of the various constituents of the project. History does
show you that in setting about the discharge of programmes there
are areas which cause difficulty. Certainly my experience of British
Central Government has been that one of the areas that has caused
difficulty, and indeed one of the witnesses mentioned the Small
Business Service, is actually getting people to work together,
making arrangements to focus their efforts. The idea at this stage
of looking at one of the elements that has to be got right if
success is to be achieved lies behind the decision to do this
piece of work.

98. You do not need to delineate if you do not
care whether the consequence is as a result of poor joint working
or just because the people running it are no good or whatever.
I do want to pursue this a bit more, Chairman, because I am very
concerned about the displacement activity and that is what I feel
this report is in a way. Let us look at Sure Start. It says in
the report that your objectives cover improving the social, emotional
and physical development of young children. That is what wants
to be measured. Then it says "Impact. It is too early for
there to be any measurable benefit from Sure Start programmes".
How useful is the report on that?
(Sir John Bourn) I will ask Mr Whitehouse to comment
on it. You can certainly look at programmes before they produce
their outcomes and you can look, for example, at what are the
arrangements for handling the money in the programmes. It is often
the case that you set up a programme and unless you have got in
place the question of how the money is to be handled, who is to
be responsible for spending it, how reports are to be made on
it, that is something that you need to look at and make sure you
have got it right.

99. They should be in place through the public
sector, and I hope they are in place. I do not really see that
needs a separate report. Those audit trails should be there when
any penny of public money is spent, surely.
(Sir John Bourn) They should be there and it is important
to make sure they are there. Very often if you are starting something
new experience shows that these things are not always in place
automatically. It is part of the function of the external auditor
in looking at continuing programmes to look at those kind of things,
I mentioned one example of the kind of thing that is worth thinking
about before you reach the stage of being able to investigate
the final outcome.
(Mr Whitehouse) The observation I make is that we
started from the premise that the Committee in its previous reports
had raised a number of issues of concern that government programmes
have not been effective in delivery and identified areas where
improvements were needed, the lack of shared goals. I was referring
to table 10, where the Committee in the past has raised a number
of issues of concern, the lack of shared goals, sufficient and
inappropriate resources not being available, the lack of performance
measurement, the importance of working together, the need for
clear accountability and services. I think these are important
observations that were made. We looked at Sure Start because it
is a significant programme. I think table four sets out the expenditure
on Sure Start which I think increases to nearly £500 million
in 2003-04. Although we cannot yet form an absolute judgment to
the extent to which Sure Start is meeting its objectives what
we were doing in this Report is looking to assess the extent to
which it met some of the concerns that the Committee has made
in the past to ensure that the infrastructure, resources and skills
are in place to hopefully ensure its success. I think you were
right at this point in time to form an interim assessment and
we have found that a lot of those points are being addressed.
There is scope for that good practice to be replicated in other
programmes. That is the purpose of this Report.